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Kim BE, Hui-Beckman J, Lyubchenko T, Hall CF, Fallahi S, Brull A, Goleva E, Leung DY. Transient Receptor Potential Vanilloid 1 Plays a Major Role in Low Temperature-Mediated Skin Barrier Dysfunction. J Allergy Clin Immunol 2022; 150:362-372.e7. [PMID: 35189126 DOI: 10.1016/j.jaci.2022.01.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 12/23/2021] [Accepted: 01/26/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Children born in the fall and winter are at increased risk for developing atopic dermatitis (AD) and food allergy (FA). Since these seasons are associated with low temperature, we hypothesized that low temperature exposure may compromise keratinocyte differentiation and contribute to skin barrier dysfunction. OBJECTIVE To examine whether low temperature causes skin barrier dysfunction. METHODS Primary human epidermal keratinocytes (HEKs) were differentiated in 1.3mM CaCl2 media and cultured at different temperatures. The cells were transfected with transient receptor potential cation channel subfamily V member 1 (TRPV1) or signal transducer and activator of transcription (STAT) 3 small-interfering RNA (siRNA) to examine the effects of these gene targets in HEKs exposed to low temperature. Gene expression of TRPV1, epidermal barrier proteins, and keratinocyte-derived cytokines were evaluated. Organotypic skin equivalents were generated using HEKs transfected with control or TRPV1 siRNA and grown at 25oC or 37oC. Transepidermal water loss (TEWL) and levels of epidermal barrier proteins were evaluated. RESULTS Filaggrin (FLG) and loricrin (LOR) expression, but not keratin (KRT)-1 and KRT-10 expression, was downregulated in HEKs incubated at 25oC while TRPV1 silencing increased intracellular Ca2+ influx (keratinocyte differentiation signal) and enhanced the expression of epidermal differentiation proteins. Interleukin (IL)-1β and thymic stromal lymphopoietin (TSLP) induced by low temperature inhibited FLG expression in keratinocytes through the TRPV1/STAT3 pathway. Moreover, low temperature-mediated inhibition of FLG and LOR was recovered, and TEWL was decreased in organotypic skin transfected with TRPV1 siRNA. CONCLUSION TRPV1 is critical in low temperature-mediated skin barrier dysfunction. Low temperature exposure induced TSLP, an alarmin implicated in epicutaneous allergen sensitization. CLINICAL IMPLICATIONS Low temperature causes skin barrier dysfunction through TRPV1 and TSLP, which may explain the pathways involved in promoting allergic sensitization through the skin.
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Affiliation(s)
- Byung Eui Kim
- Department of Pediatrics, National Jewish Health, Denver, CO, 80206
| | | | - Taras Lyubchenko
- Department of Pediatrics, National Jewish Health, Denver, CO, 80206; Department of Biological Science, University of Denver, Denver, CO, 80208
| | - Clifton F Hall
- Department of Pediatrics, National Jewish Health, Denver, CO, 80206
| | - Sahand Fallahi
- Department of Pediatrics, National Jewish Health, Denver, CO, 80206; Department of Biological Science, University of Denver, Denver, CO, 80208
| | - Amelia Brull
- Department of Pediatrics, National Jewish Health, Denver, CO, 80206
| | - Elena Goleva
- Department of Pediatrics, National Jewish Health, Denver, CO, 80206
| | - Donald Ym Leung
- Department of Pediatrics, National Jewish Health, Denver, CO, 80206
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Hui-Beckman J, Kim BE, Leung DY. Origin of Allergy From In Utero Exposures to the Postnatal Environment. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2022; 14:8-20. [PMID: 34983104 PMCID: PMC8724834 DOI: 10.4168/aair.2022.14.1.8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/28/2021] [Accepted: 07/11/2021] [Indexed: 04/28/2023]
Abstract
As the incidence of atopic conditions continues to increase, emphasis has been placed on understanding the origin of allergy with hope that prevention measures can be achieved. The perinatal environment is important for this understanding, given that both the immune system and microbiome start forming prenatally. Maternal exposure can greatly impact on fetal health. Additionally, the dysfunctional epithelial barrier is influential in allowing allergens and irritants to penetrate the skin or mucosa, leading to the release of proinflammatory cytokines and mediators to drive type 2 tissue inflammation and the onset of allergy. There are numerous factors related to skin, airway, and gut epithelial barriers dysfunction, and genetic predispositions are also present. Comprehensive birth cohort studies and further mechanistic studies will be keys to understanding the origin of allergy.
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Affiliation(s)
| | - Byung Eui Kim
- Department of Pediatrics, National Jewish Health, Denver, CO 80206, USA
| | - Donald Ym Leung
- Department of Pediatrics, National Jewish Health, Denver, CO 80206, USA.
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Xue M, Wang Q, Zhang Y, Pang B, Yang M, Deng X, Zhang Z, Niu W. Factors Associated With Lower Respiratory Tract Infection Among Chinese Students Aged 6-14 Years. Front Pediatr 2022; 10:911591. [PMID: 35783299 PMCID: PMC9243225 DOI: 10.3389/fped.2022.911591] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 05/23/2022] [Indexed: 12/03/2022] Open
Abstract
AIMS We employed machine-learning methods to explore data from a large survey on students, with the goal of identifying and validating a thrifty panel of important factors associated with lower respiratory tract infection (LRTI). METHODS Cross-sectional cluster sampling was performed for a survey of students aged 6-14 years who attended primary or junior high school in Beijing within January, 2022. Data were collected via electronic questionnaires. Statistical analyses were completed using the PyCharm (Edition 2018.1 x64) and Python (Version 3.7.6). RESULTS Data from 11,308 students (5,527 girls and 5,781 boys) were analyzed, and 909 of them had LRTI with the prevalence of 8.01%. After a comprehensive evaluation, the Gaussian naive Bayes (gNB) algorithm outperformed the other machine-learning algorithms. The gNB algorithm had accuracy of 0.856, precision of 0.140, recall of 0.165, F1 score of 0.151, and area under the receiver operating characteristic curve (AUROC) of 0.652. Using the optimal gNB algorithm, top five important factors, including age, rhinitis, sitting time, dental caries, and food or drug allergy, had decent prediction performance. In addition, the top five factors had prediction performance comparable to all factors modeled. For example, under the sequential deep-learning model, the accuracy and loss were separately gauged at 92.26 and 25.62% when incorporating the top five factors, and 92.22 and 25.52% when incorporating all factors. CONCLUSIONS Our findings showed the top five important factors modeled by gNB algorithm can sufficiently represent all involved factors in predicting LRTI risk among Chinese students aged 6-14 years.
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Affiliation(s)
- Mei Xue
- Graduate School, Beijing University of Chinese Medicine, Beijing, China.,Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China
| | - Qiong Wang
- Graduate School, Beijing University of Chinese Medicine, Beijing, China.,Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China
| | - Yicheng Zhang
- Graduate School, Beijing University of Chinese Medicine, Beijing, China.,Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China
| | - Bo Pang
- Graduate School, Beijing University of Chinese Medicine, Beijing, China.,Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China
| | - Min Yang
- Graduate School, Beijing University of Chinese Medicine, Beijing, China.,Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China
| | - Xiangling Deng
- Graduate School, Beijing University of Chinese Medicine, Beijing, China.,Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China
| | - Zhixin Zhang
- Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China.,International Medical Services, China-Japan Friendship Hospital, Beijing, China
| | - Wenquan Niu
- Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, China
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Manohar M, Dunham D, Gupta S, Yan Z, Zhang W, Minnicozzi S, Kirkey M, Bunning B, Roy Chowdhury R, Galli SJ, Boyd SD, Kost LE, Chinthrajah RS, Desai M, Oettgen HC, Maecker HT, Yu W, DeKruyff RH, Andorf S, Nadeau KC. Immune changes beyond Th2 pathways during rapid multifood immunotherapy enabled with omalizumab. Allergy 2021; 76:2809-2826. [PMID: 33782956 DOI: 10.1111/all.14833] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 02/03/2021] [Accepted: 02/15/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Multifood oral immunotherapy (mOIT) with adjunctive anti-IgE (omalizumab, XOLAIR® ) treatment affords safe, effective, and rapid desensitization to multiple foods, although the specific immune mechanisms mediating this desensitization remain to be fully elucidated. METHODS Participants in our phase 2 mOIT trial (NCT02643862) received omalizumab from baseline to week 16 and mOIT from week 8 to week 36. We compared the immune profile of PBMCs and plasma taken at baseline, week 8, and week 36 using high-dimensional mass cytometry, component-resolved diagnostics, the indirect basophil activation test, and Luminex. RESULTS We found (i) decreased frequency of IL-4+ peanut-reactive CD4+ T cells and a marked downregulation of GPR15 expression and CXCR3 frequency among γδ and CD8+ T-cell subsets at week 8 during the initial, omalizumab-alone induction phase; (ii) significant upregulation of the skin-homing receptor CCR4 in peanut-reactive CD4+ T and Th2 effector memory (EM) cells and of cutaneous lymphocyte-associated antigen (CLA) in peanut-reactive CD8+ T and CD8+ EM cells; (iii) downregulation of CD86 expression among antigen-presenting cell subsets; and (iv) reduction in pro-inflammatory cytokines, notably IL-17, at week 36 post-OIT. We also observed significant attenuation of the Th2 phenotype post-OIT, defined by downregulation of IL-4 peanut-reactive T cells and OX40 in Th2EM cells, increased allergen component-specific IgG4/IgE ratio, and decreased allergen-driven activation of indirectly sensitized basophils. CONCLUSIONS This exploratory study provides novel comprehensive insight into the immune underpinnings of desensitization through omalizumab-facilitated mOIT. Moreover, this study provides encouraging results to support the complex immune changes that can be induced by OIT.
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Affiliation(s)
- Monali Manohar
- Sean N. Parker Center for Allergy and Asthma Research Stanford CA USA
| | - Diane Dunham
- Sean N. Parker Center for Allergy and Asthma Research Stanford CA USA
| | - Sheena Gupta
- Human Immune Monitoring Center Institute for Immunity, Transplantation, and Infection Stanford University School of Medicine Stanford CA USA
| | - Zheng Yan
- Sean N. Parker Center for Allergy and Asthma Research Stanford CA USA
| | - Wenming Zhang
- Sean N. Parker Center for Allergy and Asthma Research Stanford CA USA
| | - Samantha Minnicozzi
- Division of Immunology Department of Pediatrics Boston Children's Hospital Boston MA USA
- Department of Pediatrics Harvard Medical School Boston MA USA
| | - Matthew Kirkey
- Sean N. Parker Center for Allergy and Asthma Research Stanford CA USA
| | - Bryan Bunning
- Sean N. Parker Center for Allergy and Asthma Research Stanford CA USA
| | - Roshni Roy Chowdhury
- Department of Microbiology and Immunology Stanford University School of Medicine Stanford CA USA
| | - Stephen J. Galli
- Sean N. Parker Center for Allergy and Asthma Research Stanford CA USA
- Department of Microbiology and Immunology Stanford University School of Medicine Stanford CA USA
- Department of Pathology Stanford University School of Medicine Stanford CA USA
| | - Scott D. Boyd
- Sean N. Parker Center for Allergy and Asthma Research Stanford CA USA
- Department of Pathology Stanford University School of Medicine Stanford CA USA
| | | | | | - Manisha Desai
- Department of Biomedical and Data Science Stanford University Stanford CA USA
| | - Hans C. Oettgen
- Division of Immunology Department of Pediatrics Boston Children's Hospital Boston MA USA
- Department of Pediatrics Harvard Medical School Boston MA USA
| | - Holden T. Maecker
- Human Immune Monitoring Center Institute for Immunity, Transplantation, and Infection Stanford University School of Medicine Stanford CA USA
- Department of Microbiology and Immunology Stanford University School of Medicine Stanford CA USA
| | - Wong Yu
- Sean N. Parker Center for Allergy and Asthma Research Stanford CA USA
| | | | - Sandra Andorf
- Sean N. Parker Center for Allergy and Asthma Research Stanford CA USA
- Department of Pediatrics University of Cincinnati College of Medicine Cincinnati OH USA
- Divisions of Biomedical Informatics and Allergy & Immunology Cincinnati Children’s Hospital Medical Center Cincinnati OH USA
| | - Kari C. Nadeau
- Sean N. Parker Center for Allergy and Asthma Research Stanford CA USA
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Fiocchi A, Vickery BP, Wood RA. The use of biologics in food allergy. Clin Exp Allergy 2021; 51:1006-1018. [PMID: 33966304 DOI: 10.1111/cea.13897] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 04/29/2021] [Accepted: 04/30/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Food allergy continues to pose problems due to its increased frequency and its increasingly high severity. In this context, alongside the traditional avoidance strategies of allergenic foods and desensitization through the cautious progression of exposure to foods in the context of oral immunotherapy (OIT), alternative strategies have made their way in the last decades. We review the possibilities of intervention in food allergy with the use of biological drugs capable of interfering with the synthesis of IgE, with their mechanisms of action, or with complex biological mechanisms that lead to the establishment of a food allergy. METHODS Repeated Entrez PubMed searches using the template algorithm "Food allergy" and "biologics" or "Omalizumab" or "Dupilumab" or "milk desensitization" or "oral tolerance induction" or "oral immunotherapy" or "Etokimab" or "Tezepelumab" or "Quilizumab" or "Ligelizumab" or "Tralokinumab" or "Nemolizumab" or "Mepolizumab" or "Reslizumab" or "Benralizumab". The authors' clinical experience in paediatric allergy units of University hospitals was also drawn upon. RESULTS The landscape in this context has changed dramatically over the past 10 years. We have acquired knowledge mainly on the effect of different types of anti-IgE treatments in poliallergic patients with food allergy, and in patients treated with OIT. However, other mediators are being targeted by specific biologic treatments. Among them, the alarmins Il-33 and TSLP, IL-4 and IL-13, eosinophil-related molecules as IL-6, IL-8, IL-10, IL-12, and mostly IL-5, and integrins involved in the pathogenesis of eosinophilic gastrointestinal diseases (EGIDs), as SIGLEC-8. CONCLUSIONS The ever-better knowledge of the mechanisms of food allergy allowing these developments will improve not only the perspective of patients with the most serious immediate food allergies such as anaphylaxis, but also those of patients with related diseases such as atopic dermatitis, eosinophilic esophagitis, and EGIDs. Biologics are also intended to complement OIT strategies that have developed over the years.
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Affiliation(s)
| | | | - Robert A Wood
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Krempski JW, Warren C, Han X, Zhang W, He Z, Lejeune S, Nadeau K. Food Allergies: An Example of Translational Research. Immunol Allergy Clin North Am 2021; 41:143-163. [PMID: 33863476 DOI: 10.1016/j.iac.2021.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Food allergies have been rising in prevalence since the 1990s, imposing substantial physical, psychosocial, and economic burdens on affected patients and their families. Until recently, the only therapy for food allergy was strict avoidance of the allergenic food. Recent advances in translational studies, however, have led to insights into allergic sensitization and tolerance. This article provides an overview of cutting-edge research into food allergy and immune tolerance mechanisms utilizing mouse models, human studies, and systems biology approaches. This research is being translated and implemented in the clinical setting to improve diagnosis and reduce food allergy's public health burden.
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Affiliation(s)
- James Walter Krempski
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Stanford, CA, USA.
| | - Christopher Warren
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Stanford, CA, USA
| | - Xiaorui Han
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Stanford, CA, USA
| | - Wenming Zhang
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Stanford, CA, USA
| | - Ziyuan He
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Stanford, CA, USA
| | - Stéphanie Lejeune
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Stanford, CA, USA
| | - Kari Nadeau
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Stanford, CA, USA
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Krempski JW, Dant C, Nadeau KC. The origins of allergy from a systems approach. Ann Allergy Asthma Immunol 2020; 125:507-516. [PMID: 32702411 DOI: 10.1016/j.anai.2020.07.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 07/10/2020] [Accepted: 07/14/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The origins of allergic diseases have traditionally been explained by immunoglobulin E-mediated immune responses to account for asthma, atopic dermatitis, atopic rhinitis, and food allergy. Research insights into disease origins support a broader array of factors that predispose, initiate, or exacerbate altered immunity in allergic diseases, such as (1) inherent epithelial barrier dysfunction; (2) loss of immune tolerance; (3) disturbances in the gut; and (4) organ-specific microbiomes, diet, and age. Here, we discuss these influences that together form a better understanding of allergy as a systems disease. DATA SOURCES We summarize recent advances in epithelial dysfunction, environmental influences, inflammation, infection, alterations in the specific microbiome, and inherent genetic predisposition. STUDY SELECTIONS We performed a literature search targeting primary and review articles. RESULTS We explored microbial-epithelial-immune interactions underlying the early-life origins of allergic disorders and evaluated immune mechanisms suggesting novel disease prevention or intervention strategies. Damage to epithelial surfaces lies at the origin of various manifestations of allergic disease. As a sensor of environmental stimuli, the epithelium of the lungs, gut, and skin is affected by an altered microbiome, air pollution, food allergens in a changed diet, and chemicals in modern detergents. This collectively leads to alterations of lung, skin, or gut epithelial surfaces, driving a type 2 immune response that underlies atopic diseases. Treatment and prevention of allergic diseases include biologics, oral desensitization, targeted gut microbiome alterations, and changes in behavior. CONCLUSION Understanding the spectrum of allergy as a systems disease will allow us to better define the mechanisms of allergic disorders and improve their treatment.
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Affiliation(s)
- James Walter Krempski
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Stanford, California
| | - Christopher Dant
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Stanford, California
| | - Kari C Nadeau
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Stanford, California; Department of Medicine, Stanford University School of Medicine, Stanford, California.
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Hui JW, Leung DYM. Origins of allergic disease: Maternal and early childhood factors. Ann Allergy Asthma Immunol 2020; 125:501-502. [PMID: 32445669 DOI: 10.1016/j.anai.2020.05.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 05/04/2020] [Accepted: 05/12/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Jessica W Hui
- Department of Pediatrics, National Jewish Health, Denver, Colorado
| | - Donald Y M Leung
- Department of Pediatrics, National Jewish Health, Denver, Colorado.
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Cho YJ. Does the Difference in Microbial Patterns in the Airways Induce Distinct Endotypes of Asthma? ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2020; 12:375-377. [PMID: 32141252 PMCID: PMC7061159 DOI: 10.4168/aair.2020.12.3.375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 02/28/2020] [Indexed: 11/20/2022]
Affiliation(s)
- Young Joo Cho
- Department of Allergy and Clinical Immunology, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Korea.
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